Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study
Abstract Acute healthcare services are extremely important, particularly during the COVID-19 pandemic, as healthcare demand has rapidly intensified, and resources have become insufficient. Studies on specific prepandemic hospitalization and emergency department visit (EDV) trends in proximity to dea...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-00648-1 |
| _version_ | 1819002072995987456 |
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| author | Claudio Barbiellini Amidei Silvia Macciò Anna Cantarutti Francesca Gessoni Andrea Bardin Loris Zanier Cristina Canova Lorenzo Simonato |
| author_facet | Claudio Barbiellini Amidei Silvia Macciò Anna Cantarutti Francesca Gessoni Andrea Bardin Loris Zanier Cristina Canova Lorenzo Simonato |
| author_sort | Claudio Barbiellini Amidei |
| collection | DOAJ |
| description | Abstract Acute healthcare services are extremely important, particularly during the COVID-19 pandemic, as healthcare demand has rapidly intensified, and resources have become insufficient. Studies on specific prepandemic hospitalization and emergency department visit (EDV) trends in proximity to death are limited. We examined time-trend specificities based on sex, age, and cause of death in the last 2 years of life. Datasets containing all hospitalizations and EDVs of elderly residents in Friuli-Venezia Giulia, Italy (N = 411,812), who died between 2002 and 2014 at ≥ 65 years, have been collected. We performed subgroup change-point analysis of monthly trends in the 2 years preceding death according to sex, age at death (65–74, 75–84, 85–94, and ≥ 95 years), and main cause of death (cancer, cardiovascular, or respiratory disease). The proportion of decedents (N = 142,834) accessing acute healthcare services increased exponentially in proximity to death (hospitalizations = 4.7, EDVs = 3.9 months before death). This was inversely related to age, with changes among the youngest and eldest decedents at 6.6 and 3.5 months for hospitalizations and at 4.6 and 3.3 months for EDVs, respectively. Healthcare use among cancer patients intensified earlier in life (hospitalizations = 6.8, EDVs = 5.8 months before death). Decedents from respiratory diseases were most likely to access hospital-based services during the last month of life. No sex-based differences were found. The greater use of acute healthcare services among younger decedents and cancer patients suggests that policies potentiating primary care support targeting these at-risk groups may reduce pressure on hospital-based services. |
| first_indexed | 2024-12-20T22:59:18Z |
| format | Article |
| id | doaj.art-d28de7d7537a4aa1912f0155115a36f2 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-20T22:59:18Z |
| publishDate | 2021-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d28de7d7537a4aa1912f0155115a36f22022-12-21T19:24:03ZengNature PortfolioScientific Reports2045-23222021-11-0111111010.1038/s41598-021-00648-1Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based studyClaudio Barbiellini Amidei0Silvia Macciò1Anna Cantarutti2Francesca Gessoni3Andrea Bardin4Loris Zanier5Cristina Canova6Lorenzo Simonato7Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of PaduaDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of PaduaDivision of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-BicoccaDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of PaduaDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of PaduaEpidemiological Service, Health DirectorateDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of PaduaDepartment of Cardio-Thoraco-Vascular Sciences and Public Health, University of PaduaAbstract Acute healthcare services are extremely important, particularly during the COVID-19 pandemic, as healthcare demand has rapidly intensified, and resources have become insufficient. Studies on specific prepandemic hospitalization and emergency department visit (EDV) trends in proximity to death are limited. We examined time-trend specificities based on sex, age, and cause of death in the last 2 years of life. Datasets containing all hospitalizations and EDVs of elderly residents in Friuli-Venezia Giulia, Italy (N = 411,812), who died between 2002 and 2014 at ≥ 65 years, have been collected. We performed subgroup change-point analysis of monthly trends in the 2 years preceding death according to sex, age at death (65–74, 75–84, 85–94, and ≥ 95 years), and main cause of death (cancer, cardiovascular, or respiratory disease). The proportion of decedents (N = 142,834) accessing acute healthcare services increased exponentially in proximity to death (hospitalizations = 4.7, EDVs = 3.9 months before death). This was inversely related to age, with changes among the youngest and eldest decedents at 6.6 and 3.5 months for hospitalizations and at 4.6 and 3.3 months for EDVs, respectively. Healthcare use among cancer patients intensified earlier in life (hospitalizations = 6.8, EDVs = 5.8 months before death). Decedents from respiratory diseases were most likely to access hospital-based services during the last month of life. No sex-based differences were found. The greater use of acute healthcare services among younger decedents and cancer patients suggests that policies potentiating primary care support targeting these at-risk groups may reduce pressure on hospital-based services.https://doi.org/10.1038/s41598-021-00648-1 |
| spellingShingle | Claudio Barbiellini Amidei Silvia Macciò Anna Cantarutti Francesca Gessoni Andrea Bardin Loris Zanier Cristina Canova Lorenzo Simonato Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study Scientific Reports |
| title | Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study |
| title_full | Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study |
| title_fullStr | Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study |
| title_full_unstemmed | Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study |
| title_short | Hospitalizations and emergency department visits trends among elderly individuals in proximity to death: a retrospective population-based study |
| title_sort | hospitalizations and emergency department visits trends among elderly individuals in proximity to death a retrospective population based study |
| url | https://doi.org/10.1038/s41598-021-00648-1 |
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